European review for medical and pharmacological sciences最新文献

BACKGROUND: Foodborne botulism is a rare but potentially serious and lethal disease that is considered a threat to public health systems across the globe. Botulism is a paralytic disorder caused by the neurotoxin, produced by Clostridium botulinum, which acts upon peripheral cholinergic nerve terminals by inhibiting acetylcholine release, subsequently causing denervation to muscle fibers. CASE SERIES: In April 2024, an outbreak of foodborne botulism was reported in Riyadh, Saudi Arabia, following consumption of contaminated fast food. Four patients were affected: two females and two males, aged 14 to 21 years. All patients developed neurological symptoms, including cranial nerve involvement, dysphagia, and generalized weakness. Three patients progressed to severe hypercapnic respiratory failure requiring prolonged mechanical ventilation. Electrophysiological studies demonstrated characteristic findings of presynaptic neuromuscular junction dysfunction. CONCLUSIONS: This case series adds to existing knowledge by providing detailed descriptions of the clinical course, neurological examination findings, and electrodiagnostic features of foodborne botulism cases in Saudi Arabia. Our findings highlight that, despite early antitoxin administration, patients can develop prolonged neuromuscular weakness requiring extended mechanical ventilation. This underscores the importance of considering botulism in the differential diagnosis of acute flaccid paralysis and the need for timely electrophysiological evaluation to guide management and prognosis.

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Parkinson's disease (PD) is a progressive neurodegenerative disorder characterized by the loss of nigrostriatal dopaminergic neurons and pathological aggregation of a-synuclein. Despite advancements in symptomatic treatment, there is a critical unmet need for disease-modifying therapies capable of halting or slowing disease progression. Drug repurposing offers an efficient, cost-effective strategy to identify new treatments by leveraging the established safety and pharmacokinetic profiles of existing compounds. Dimethyl fumarate (DMF), an FDA-approved drug for multiple sclerosis and psoriasis, has recently emerged as a promising neuroprotective agent in PD research. Preclinical studies consistently demonstrate that DMF exerts beneficial effects in both in vitro and in vivo PD models, primarily via activation of the nuclear factor erythroid 2-related factor 2 (Nrf2) pathway. Through this mechanism, DMF counters oxidative stress, reduces neuroinflammation, promotes mitochondrial quality control, and impedes pathological protein aggregation. These biological effects translate into the preservation of dopaminergic neurons and improvements in motor behavior in animal models. Although direct clinical evidence of DMF's efficacy in PD patients is currently very limited, early mechanistic human studies provide indirect support for the targeting of the Nrf2 pathway in PD. Furthermore, DMF's neuroprotective properties extend to other neurodegenerative diseases, underscoring its broader therapeutic potential. In conclusion, the strong preclinical foundation, combined with an established clinical safety record, makes DMF an attractive candidate for repurposing as a disease-modifying therapy for PD. Future clinical trials will be essential to validate these preclinical promises and define DMF's role in the management of PD.

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OBJECTIVE: The astrocyte-neuron lactate shuttle is the mechanism by which astrocytic lactate is transferred to neurons to maintain brain function and is modulated by astrocytic glycogen content. The aims of this study were to determine whether mulberry leaf extracts promote astrocytic glycogen accumulation and to explore the active compounds of mulberry leaf extracts. MATERIALS AND METHODS: Glycogen content was determined in human-induced pluripotent stem cell-derived astrocytes treated with mulberry leaf extracts or their active compounds. To determine the involvement of active compounds in glycogen synthesis and degradation, human-induced pluripotent stem cell-derived astrocytes were treated with glucose-free medium containing 13C-glucose, and the amounts of 12C- and 13C-glucose in glycogen were quantified. RESULTS: Mulberry leaf extracts promoted astrocytic glycogen accumulation. Iminosugars in mulberry leaf extracts did not significantly increase the glycogen content of astrocytes. In contrast, several quercetin glycosides exhibited some of the activities of the mulberry leaf extracts. Quercetin aglycone, the basic backbone structure without glycosides, increased astrocytic glycogen content. Additionally, quercetin aglycone increased both 12C- and 13C-glucose contents, meaning it promoted glycogen synthesis and inhibited glycogen breakdown. CONCLUSIONS: In this study, quercetin glycosides were identified as active compounds present in mulberry leaf extracts. The principal compound responsible for the activity was identified as quercetin aglycone. Mulberry leaf extracts and quercetin analogs may induce astrocyte-neuron lactate shuttling by promoting the accumulation of glycogen in astrocytes.

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BACKGROUND: Spinal and bulbar muscular atrophy (SBMA) is a rare X-linked neuromuscular disorder characterized by progressive muscle weakness and endocrine abnormalities. Beyond its classic neurological presentation, SBMA is increasingly associated with metabolic and cardiovascular comorbidities, including dyslipidemia and insulin resistance.   CASE REPORT: We present the case of a 54-year-old male with genetically confirmed SBMA and high cardiovascular risk, in whom statins and ezetimibe were contraindicated due to persistently elevated creatine kinase levels and underlying muscle involvement. Coronary CT angiography revealed subclinical atherosclerosis. Alirocumab, a PCSK9 inhibitor, was initiated at a dose of 150 mg every 2 weeks. After six months, LDL cholesterol was reduced by 54.9% without adverse effects or functional decline, and CK levels remained stable.   CONCLUSIONS: This case highlights the potential role of PCSK9 inhibitors as a safe and effective lipid-lowering option in patients with neuromuscular disorders at high cardiovascular risk, for whom traditional therapies are not feasible. It also highlights the importance of integrated cardiovascular care in managing multisystem diseases, such as SBMA.

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The article "Long noncoding RNA MNX1-AS1 overexpression promotes the invasion and metastasis of gastric cancer through repressing CDKN1A" by J.-X. Ma, Y.-L. Yang, X.-Y. He, X.-M. Pan, Z. Wang, Y.-W. Qian, published in Eur Rev Med Pharmacol Sci 2019; 23 (11): 4756-4762 DOI: 10.26355/eurrev_201906_18057-PMID: 31210302 has been retracted by in accordance with the Publisher and the Editor in Chief. Following some concerns on PubPeer, the authors were informed of the ongoing investigation and were asked to provide original data and clarify several other issues but remained unresponsive. The journal's investigation confirmed the duplication detected in Figure 3C and D and therefore the manuscript is retracted for Figure duplication. This article has been retracted. The Publisher apologizes for any inconvenience this may cause. https://www.europeanreview.org/article/18057.

BACKGROUND: Subungual splinter hemorrhages may represent an expression of infective endocarditis as well as autoimmune diseases or neoplasms. Anti-SAE1 autoantibody is directed against a small ubiquitin-like modifier-activating enzyme that plays a role in regulating transcription, cell cycle, and apoptosis. It is specific for dermatomyositis with skin rash and mild muscle involvement, and it can be associated with cancer.  CASE REPORT: We describe the case of a patient who developed subungual splinter hemorrhages and acrocyanosis. Infections were excluded, and autoimmunity resulted in anti-SAE1 autoantibodies. A cancer screening found a high-grade urothelial carcinoma. The splinter hemorrhages disappeared after the carcinoma enucleation.  CONCLUSIONS: Our case describes an atypical onset of anti-SAE1 dermatomyositis with splinter hemorrhages, potentially linked to urothelial cancer. This highlights the importance of comprehensive cancer screening in patients with unusual dermatomyositis presentations.

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Correction to: Eur Rev Med Pharmacol Sci 2023; 27 (4): 1474-1479-DOI: 10.26355/eurrev_202302_31387-PMID: 36876687 published online on 1 March 2023.  This erratum serves to include the ethics approval date and approval number, which were unintentionally omitted from the originally published online version of the article.  Therefore, the Ethics Approval statement has been corrected as follows:  Institutional ethics approval was obtained from the Clinical Research Ethics Committee of the Faculty of Medicine, Ataturk University on May 30, 2019, with approval number 241, and informed consent was provided by all the participants.  There are amendments to this paper. The Publisher apologizes for any inconvenience this may cause.  https://www.europeanreview.org/article/31387.

OBJECTIVE: In this multicenter study, we assessed the effectiveness of a novel autologous bone substitute obtained directly from the processing of extracted teeth. A total of 34 consecutive tooth grafting procedures were performed.  MATERIALS AND METHODS: Immediately following atraumatic extraction for restorative or endodontic purposes, the bone defect was filled and covered with an Osseoguard© membrane, using autologous material derived from the extracted tooth. Zimvie T3 PRO© implants with platform switching were placed in 34 patients.   RESULTS: After a 5-month healing period, the defects were significantly filled with newly formed hard tissue. Bone biopsies were subsequently taken during dental implant placement to assess histological outcomes. The tissue demonstrated a density comparable to medium-density bone, with a homogeneous and uniform appearance, showing no visible signs of inflammation. The post-operative healing phase was uneventful, with no infectious complications or evidence of graft particles within the regenerated bone structure. Histomorphometric analyses revealed the following results: average bone volume (BV) of 52.35% (±17.25). The average residual graft (RG) rate was 10.79% (±12.26), while new bone (NB) accounted for 41.56% (±22.02) of the samples.  CONCLUSIONS: Bone grafts resorb very quickly, while xenograft materials maintain space over time, facilitating bone regeneration. Unfortunately, xenograft materials are not osteoinductive, meaning they do not stimulate bone growth; rather, they provide a supportive structure for new bone formation. The findings of the current study revealed a significant increase in three-dimensional bone volume and a substantial percentage of vital bone formation across all socket preservation sites. The possibility of transforming the extracted tooth of the patient chairside into suitable osteoinductive grafting material offers interesting perspectives in the field of bone regeneration for dental implant purposes. The study demonstrated successful bone healing in guided regenerative surgery procedures utilizing autologous tooth grafts. However, further research with an extended follow-up period is necessary to fully evaluate the potential of demineralized dentin autografts.

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OBJECTIVE: Parapneumonic effusion (PPE), a pneumonia-related complication, can progress to complicated PPE (CPPE) and often requires invasive treatment. Although early differentiation is essential, the diagnostic role of hematological inflammatory markers remains unclear. This study evaluated hematological inflammatory markers to distinguish between pleural effusion types, particularly CPPE and uncomplicated PPE (uCPPE), in order to identify the most reliable biomarkers.  MATERIALS AND METHODS: This retrospective study analyzed 94 cases of pleural effusion classified as transudative, malignant, tuberculous, or PPE. PPE was further divided into CPPE and uCPPE. C-reactive protein (CRP) and procalcitonin (PCT) levels, systemic immune-inflammation index (SII), systemic inflammation response index (SIRI), CRP/albumin-globulin ratio (CAGR), albumin-globulin ratio (AGR), neutrophil-to-lymphocyte ratio (NLR), monocyte-to-lymphocyte ratio (MLR), and platelet-lymphocyte ratio (PLR) were analyzed. Receiver Operating Characteristic (ROC) curve analysis was used to determine the diagnostic accuracy via the area under the curve (AUC) and optimal cut-off values.  RESULTS: Inflammatory markers effectively differentiated pleural effusion types, with CAGR showing the highest accuracy for PPE diagnosis (AUC, 0.866; cut-off: 13.75; sensitivity = 93.8%, specificity = 51.1%). Among the CPPE and uCPPE markers, MLR demonstrated the best performance (AUC: 0.707; cut-off: 3.615; sensitivity: 87.5%; specificity: 77.8%), followed by NLR (AUC: 0.702) and PLR (AUC: 0.704), whereas SIRI and SII had modest utility. Although MLR showed superior accuracy, the addition of SII improved the sensitivity.  CONCLUSIONS: This study demonstrates that among hematological markers, CAGR is the most accurate for diagnosing PPE, while MLR best distinguishes CPPE from uCPPE. However, the limited specificity of CAGR highlights the need for the combined use of biomarkers. Prospective multicenter studies are warranted to validate and refine these findings.

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Bloodstream infections (BSIs) pose a significant health burden in clinical settings, contributing to high morbidity and mortality rates worldwide. This review aims to analyze the trends of bacterial and fungal BSI and blood culture pathogen profiles reported in adolescents and adults in Southeast Asian (SEA) countries, drawing from published studies between 2018 and 2024. A comprehensive literature search was conducted via PubMed, Scopus, Web of Science, and Cochrane Library, analyzing 23 studies that included 14,512 patients from 7 SEA countries. The narrative review highlighted various prevalence rates of bacterial and fungal BSIs among different patient groups: those with indwelling catheters (0.6%-46.9%), sepsis (12.6%-44.5%), and hospitalized patients with other comorbidities (1.1%-29.5%). Blood culture findings revealed that Escherichia coli and Staphylococcus aureus were the most commonly isolated gram-negative and gram-positive bacteria, respectively, while Candida species emerged as the predominant fungal pathogen. Notably, non-albicans Candida species were more common than Candida albicans in SEA fungemia patients. The overall findings of pathogen distribution in blood cultures from SEA patients are consistent with global surveillance data; however, distinct regional pathogens endemic to SEA, particularly Burkholderia pseudomallei and Talaromyces marneffei, were also identified. Significant gaps exist in determining bacterial and fungal BSI epidemiology among vulnerable populations, including the acquisition sources, risk factors, antimicrobial resistance patterns, and mortality rates across the SEA region. Overcoming challenges arising from inadequate surveillance and diagnostic capabilities could significantly reduce the BSI burden in the region.

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